Perinatal and maternal outcomes in high risk pregnancies with fetal macrosomia at SPHMMC, 2017
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Introduction: Management of fetal macrosomia has long been an obstetric challenge, and is becoming an increasingly important problem because of its rising incidence and the associated risks to the mother and infant.
Objective: The objective of the study is to determine perinatal and maternal outcomes high risk pregnancies with fetal macrosomia at SPHMMC.
Methods: Facility based prospective cohort study was conducted among mothers who deliver at SPHMMC from May-October 2017 and data was collected with pretested structured questionnaires by BSC midwives who are trained by principal investigator, at labor ward and EGOPD. Data was entered using Epi-info and exported to SPSS for analysis. Chi-square test was used for statistical analysis of results. RR, 95% confidence interval and p-value set at 0.05 was used to determine the statistical significance of associations. Binary Logistic regression analysis was carried out to examine the association of macrosomia with different explanatory and confounding variable.
Results: During the study period a total of 344 respondents were interviewed, of which 115 women were those who gave birth to macrosomic babies while 229 women were those who gave birth to babies with normal birth weight. There was higher rate of NICU admission, and low 5th minute Apgar score, among macrosomic babies. Significant number of macrosomic neonates developed hypoglycemia. Most of mothers with macrosomic babies gave birth cesarean delivery. Higher number of mothers with macrosomic babies had PPH.
Conclusion and recommendations: Macrosomia is potentially dangerous for the mother and the neonate. We recommend that individualizing and doing cesarean section for suspected macrosomic babies deceases increased number of neonates to be transferred to NICU and having low APGAR score. We also recommend that each macrosomic neonates RBS should be done. We recommend, mothers who gave birth to macrosomic babies, should be anticipated and prophylactic measures should be taken for prevention of PPH. We also recommend further study in this area.